Simple Prostatectomy

[naples2021]

Hello everyone ,

My father was diagnosed with locally advanced prostate cancer in March of 2021, PSA 6900 … After 3 months on Eligard his PSA dropped to 0.6 and it has been so for more than 2 years now. He has been on foley catheter since March of 2021 because of a very enlarged prostate and has refused to complete a TURP procedure . His blood work , apetite has been great ,walks at least 45 min every day ; however three weeks ago he had hematuria and we rushed in the emergency room. Blood work , PSA great again except urine test showed a very bad infection and cat scan showed a lesion in the bladder … His urologist came to see him twice in the hospital and explained to me that the lesion was not a bladder mass , but his prostate gland cancer protruding the bladder and the cat scan doesn’t show it correctly .. In the hospital my father had a prostate radiation embolization procedure and now he is scheduled to have a simple Da Vinci prostatectomy to make his prostate smaller so he can get rid of the catheter .. I am so confused right now as I thought blood in the urine is associated with bladder cancer and why is he having blood in the urine with a stable PSA? Instead of focusing in the surgery why doesn’t his urologist advised me to see the oncologist if the prostate cancer has grown in size ?? I feel I am missing some parts of the puzzle .

[Justfor_]

Have you discussed with the surgeon the odds your father becoming incontinent post surgery?

[naples2021 in reply to Justfor_]

No I did not..

[Tall_Allen]

The emergent problem is his blocked-up urethra, which the TURP will relieve. I don't understand why your father or you would object.

[JGalt]

he may have developed a Neuroendocrine tumor where is prostate is and that is pushing on the bladder causing the blood. The Neuroendocrine tumor growth is not associated with a rising psa so this is how they are discovered or with scans. This exact scenario happened earlier this year with my husband and radiation and chemo reduced the size of the tumor significantly. Might want to get the oncologist involved if they are not already.

[pakb]

Urologists, as far as I can see in posts, normally recommend surgeries since that's what they do. I'd schedule a 2nd opinion with a medical oncologist that specializes in prostate cancer. He should treat his cancer with the oncologist. Blood in urine is common with prostate cancer. I'd definitely meet with the oncologist. My husband's TURP really helped with urine infections and ability to urinate.

[turkeyjoe1]

I went with the TURP, it's like night and day. What a difference. It really helps.

[Bethpage]

'Simple' prostatectomy is not 'simple.' With regards to side effects and recovery, it is exactly like RALP. My husband had simple prostatectomy in 2014. The surgery did find the tumor, but TURP would be an easier and safer treatment.

[ron_bucher]

He can (and in my opinion should) see an oncologist without being "advised" to do so by his urologist.

[TEXAS_dan2022]

Do not know your father's age but if he has "advanced" prostate cancer, and the prostate is already enlarged, I would opt to have him do the RALP and have the prostate removed. My reasoning is that, depending on what his Gleason scores were, he is at risk of having the cancer escape out of the prostate and into the seminal vesicles or other places. I decided to have the RALP done and when the final biopsy and results were posted it was found that is what happened to me and I had to have 8 weeks of radiation and went on Casodex and Lupron injections and now on Abiraterone (Zytiga). My PSA prior to surgery were only at 9.2 and if your father's was at 6900, I would try and convince him to have the prostate removed and LIVE with the results rather than have a 'ticking time bomb' in him. Hope this has helped.

Note: Side effects of the Lupron eliminate almost all of your testosterone which starves out the cancer cells. The worst side effects is that he will more than likely have to wear a 'man pad' or 'diaper' as the urine stream is affected and hard to control. While taking Lupron he would be required to take Prednisone to help protect other organs. As a note of history, I had RALP in Nov 2015, radiation in summer of 2016 and have been on the Lupron, Prednisone and Zytiga since Fall of 2016.

Pray that your father makes the wisest decision and not just one that will let him retain a little more of his 'manhood'

[naples2021]

Thank you everyone for taking your time and reply to my post. Today my father is having the simple robotic prostate surgery , tissues will be sent for biopsy.